Abstract
This mid-term process evaluation was commissioned by the U.S. Agency for International Development (USAID) Bureau for Global Health?s Office of Maternal and Child Health and Nutrition and the Office of Population and Reproductive Health. Its goal was to investigate the costs and benefits of the Moving Integrated, Quality Maternal, Newborn, and Child Health and Family Planning and Reproductive Health Services to Scale (MOMENTUM) project?s processes, working groups, and systems, and how those affect program implementation. It reviews MOMENTUM?s design hypotheses and assumptions in order to document how they have evolved due to the realities of the program environment, and it identifies potential risks to achieving MOMENTUM?s vision. This review does not focus on assessing the impact of implementation on health outcomes or on specific technical interventions. The MOMENTUM Suite of Awards consists of six flagship service delivery cooperative agreements awarded between December 2019 and September 2020. Through MOMENTUM, USAID seeks to accelerate reductions in maternal, newborn, and child mortality and morbidity in high-burden USAID partner countries. Each MOMENTUM award offers a deep understanding of different settings and approaches and is intended to work in a coordinated way across the Suite to provide specialized technical and regional expertise. The evaluation utilized an extensive desk review, key informant interviews with 89 MOMENTUM stakeholders, and an online survey as sources of evidence. While recognizing the limitations of a primarily qualitative review, the evidence indicates that MOMENTUM has succeeded in being responsive to partner needs, providing technical leadership, and adapting to the COVID-19 pandemic. Its overall approach and the idea of a Suite of awards premised on coordination, collaboration, and shared learning, though, is still a work in progress. It should be noted that the USAID Missions, which MOMENTUM is intended to serve, do not consider the functioning of MOMENTUM as a Suite one of their higher priorities. Rather, they have a greater interest in ensuring specific activities are undertaken and targets are met. Designing and implementing a mechanism such as MOMENTUM entailed some risks and missteps, especially regarding the management burden, partnering arrangements, and expectations for how MOMENTUM could clearly communicate its story as a project. In addition, although MOMENTUM quickly adjusted its activities in response, the COVID-19 pandemic undermined the sense of cohesion and collaboration among the multitude of partners at both the headquarters and the country levels. Nevertheless, there is still time for MOMENTUM to solidify this interconnected approach, as most of its awards are at or near the mid-point of implementation. Thus, recommendations are offered to strengthen how MOMENTUM can enhance its partnering opportunities; streamline its strategic communications; and ensure that monitoring, evaluation, and learning reinforce MOMENTUM?s coordinated approach.